Echocardiographic probability of pulmonary hypertension: a validation study

Area of Science:

• Cardiology
• Pulmonology
• Medical Imaging

Background:

• Pulmonary hypertension (PH) diagnosis relies on echocardiography and right heart catheterisation (RHC).
• The predictive value of echocardiography for redefined PH (mean pulmonary arterial pressure [mPAP] >20 mmHg) and pulmonary vascular disease (pulmonary vascular resistance [PVR] ≥3 Wood Units [WU]) is not well-established.

Purpose of the Study:

• To evaluate the role of echocardiography in predicting PH based on redefined diagnostic criteria.
• To assess the independent predictive value of various echocardiographic parameters for PH and PVR.

Main Methods:

• 278 patients referred for PH underwent echocardiography and RHC.
• Echocardiographic parameters including tricuspid regurgitation velocity (TRV), left ventricle (LV) eccentricity index, and right ventricle outflow tract acceleration time (RVOT-AT) were analyzed.

Main Results:

• With PH defined as mPAP >20 mmHg, 146 patients had pre-capillary PH and 94 had post-capillary PH.
• TRV ≥2.9 m/s independently predicted PH. LV eccentricity index >1.1 and RVOT-AT <105 ms/notching also predicted PVR ≥3 WU, but did not improve overall prediction accuracy.

Conclusions:

• Echocardiography is useful for assessing redefined PH probability in referral centers.
• The additional value of indirect echocardiographic signs for PH prediction is modest, and image quality can impact diagnostic accuracy.